Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 281946 | NY |
N | 111NI0900X | Internist | 281946 | NY |
NPI | 1003158130 |
---|---|
Provider Name | Dr. Pamela Joan-Yin Tieu |
First Address | New York, NY 10065-4870 |
Second Address | New York, NY 10065-4870 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2013 |
Last Update Date | 07/08/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04413663 | (05) | NY |